Int J Chron Obstruct Pulmon Dis. 2022 Sep 13;17:2229-2239. doi: 10.2147/COPD.S373595. eCollection 2022.
ABSTRACT
OBJECTIVE: This study aimed to assess whether the short-term use of macrolide antibiotics during hospitalization can reduce in-hospital all-cause mortality compared to non-macrolide treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
METHODS: A propensity score (PS) matching analysis was performed using retrospective data from the admission records of AECOPD patients in the medical general ward and medical intensive care unit of a tertiary care center between October 2015 and September 2018. The multivariable Cox proportional hazard model was performed to eliminate residual confounding after the PS analysis.
RESULTS: The mortality rate was 11.1% of 1528 admissions in the PS matching cohort. Approximately 70% of patients had respiratory failure requiring intubation on initial admission, and 34% had pneumonia. Macrolide treatment significantly reduced in-hospital mortality among AECOPD patients (adjusted hazard ratio, 0.55; 95% confidence interval 0.32-0.96; P=0.034). Clarithromycin was the most commonly prescribed macrolide (80%).
CONCLUSION: Macrolide antibiotics reduced in-hospital mortality in hospitalized AECOPD patients. The combination of antimicrobial and immunomodulatory effects of macrolide treatment could play an essential role.
PMID:36124296 | PMC:PMC9482436 | DOI:10.2147/COPD.S373595